超声监测HCG日子宫内膜厚度预测妊娠结局的Meta分析

A Meta-analysis of predicting pregnancy outcome by ultrasonic monitoring of endometrial thickness on the day of HCG administration

目的评价体外受精治疗周期中,人绒毛膜促性腺激素(HCG)注射日经阴道多普勒超声检测所获得的子宫内膜厚度(ET)对于预测妊娠结局的有效性。方法计算机检索中国知网、万方、维普、EMbase、Medline数据库,查阅有关HCG注射日经阴道多普勒超声检测所获得的ET对于预测妊娠结局研究,检索时限均从建库至2019年12月17日。按照纳入与排除标准,由2名作者单独进行文献筛选和信息提取。对所纳入研究的证据采用AXIS评价表进行质量评价,用RevMan5.3软件进行Meta分析。结果本研究共纳入研究22个,3990例研究对象。经AXIS评估,纳入的研究为中等到高等质量证据。Meta分析结果显示:妊娠组ET值为(11.45±2.50)mm,非妊娠组ET值为(10.96±2.46)mm。异质性检验提示存在显著的异质性(P<0.00001,I2=82%),妊娠组ET值显著高于非妊娠组,两组ET值差异有统计学意义[95%CI(0.29,0.89),P<0.00001]。结论ET与妊娠结局存在密切关系。妊娠组ET水平高于非妊娠组。ET有望成为预测妊娠结局的一种有价值的指标。

Objective To evaluate the effectiveness of endometrial thickness(ET)detected by transvaginal color Doppler ultrasound on the day of human chorionic gonadotropin(HCG)injection in the treatment cycle of in vitro fertilization(IVF)for predicting pregnancy outcome.Methods The databases of CNKI,WANFANG DATA,VIP,Embase and Medline were searched by computer for the studies on predicting pregnancy outcome through the ET detected by transvaginal color Doppler ultrasound on the day of HCG injection,with the retrieval scope of time set from the establishment of the databases to December 17,2019.According to the inclusion criteria and exclusion criteria,two authors conducted literature screening and information extraction independently.AXIS evaluation table was used to evaluate the quality of the evidence included into the research,and RevMan5.3 software was used for Meta-analysis.Results A total of 22 studies covering 3,990 subjects were included in this study.According to AXIS evaluation,the included studies were evidences of medium to high quality.The results of Meta-analysis showed that the ET value of the pregnancy group was(11.45±2.50)mm,and that of the non-pregnancy group was(10.96±2.46)mm.Heterogeneity test showed that there was significant heterogeneity(P<0.00001,I2=82%).The ET value of the pregnancy group was significantly higher than that of the non-pregnancy group,and the difference between the two groups in ET value was statistically significant[95%CI(0.29,0.89),P<0.00001].Conclusion ET is closely related to pregnancy outcome.The ET level of the pregnancy group was higher than that of the non-pregnancy group.ET might be a significant index for predicting pregnancy outcome.